Provider Demographics
NPI:1639450729
Name:DOWLING, JOHN WAYNE (PHARMD)
Entity Type:Individual
Prefix:
First Name:JOHN
Middle Name:WAYNE
Last Name:DOWLING
Suffix:
Gender:M
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:302 UNIVERSITY PL
Mailing Address - Street 2:
Mailing Address - City:DURANT
Mailing Address - State:OK
Mailing Address - Zip Code:74701-7110
Mailing Address - Country:US
Mailing Address - Phone:580-920-1145
Mailing Address - Fax:580-920-2361
Practice Address - Street 1:302 UNIVERSITY PL
Practice Address - Street 2:
Practice Address - City:DURANT
Practice Address - State:OK
Practice Address - Zip Code:74701-7110
Practice Address - Country:US
Practice Address - Phone:580-920-1145
Practice Address - Fax:580-920-2361
Is Sole Proprietor?:Yes
Enumeration Date:2011-09-01
Last Update Date:2011-09-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK9253183500000X
TX26209183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist